PEPFARMay 02, 2011

This week I am traveling in the Democratic Republic of the Congo (DRC), a country that, while facing many challenges, is home to families who are seeking to build a better future. Health is an important part of a better future for the DRC, and preventing mother-to-child transmission of HIV (PMTCT) is a key example of a health care service that can strengthen families and communities.

PMTCT provides a triple benefit: in addition to preventing an infant from being infected with HIV, a program can also provide antiretroviral treatment to keep the mother alive, which in turn prevents her other children from being orphaned. So PMTCT is a smart investment -- it has an impressive impact, and is strikingly cost-effective as well.

Led by the U.S. through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the world has made dramatic progress on PMTCT over the last decade. Tragically, the DRC has not been able to participate in this improvement. According to 2007 demographic and health survey (DHS) data, an estimated 70 percent of pregnant women give birth in facilities. However, only an estimated 2.2 percent of pregnant women have access to PMTCT services, including HIV testing.

We recently spoke with Deborah Parham Hopson, Associate Administrator for the HIV/AIDS Bureau at the Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services, to receive an update on the Ryan White Program. The following podcast is a brief excerpt from that conversation focusing on the AIDS Drug Assistance Program (ADAP) that we thought you would find of interest.

With efforts to implement the National HIV/AIDS Strategy (NHAS) unfolding across the country, we thought it would be valuable to gather our Federal colleagues in this region to identify ways to coordinate and collaborate in our HIV/AIDS-related activities. After all, the NHAS calls for a more coordinated national response to the epidemic. To realize the goals of the NHAS, this coordination must take place not just at the Federal level, but also at the regional, state and community levels.

As the senior Federal public health official in the region for the Department of Health and Human Services (HHS), my responsibilities encompass four major areas: prevention, preparedness, health equity, and agency-wide coordination. In this capacity, I work closely with the Office of the Assistant Secretary for Health (OASH), which has taken a lead role in forging collaborations across HHS and with other Federal departments to implement the NHAS. Borrowing from that example, we planned a joint meeting of regional staff from HHS and other Federal departments for a discussion about implementing the NHAS in this region. The HHS Region VIII encompasses Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming.

The level of enthusiasm from our partners was impressive. Joining in this conversation were regional representatives of numerous HHS agencies including the Health Services and Resources Administration (HRSA), Administration on Aging (AoA), Administration on Children and Families (ACF), Office for Civil Rights (OCR), Office of Population Affairs (OPA), Office of Minority Health (OMH), and Office on Women’s Health (OWH). In addition, representatives from the Departments of Agriculture, Education, Housing and Urban Development (HUD), Justice (DOJ), Labor (DOL), and Veterans Affairs (VA), and the Social Security Administration (SSA) joined the discussion (this list includes all of the agencies tasked by the White House with lead responsibility for implementing the Strategy as well as several other welcome additions). The broad organizational diversity of the partners, along with their collective depth of experience and perspective made for a very rich discussion.

By Christopher Bates, M.P.A., Executive Director, Presidential Advisory Council on HIV/AIDS, and Senior Advisor to the Deputy Assistant Secretary for Health, Infectious Diseases, U.S. Department of Health and Human Services

Earlier this month, I had the opportunity to spend time in Missouri speaking with audiences about the National HIV/AIDS Strategy (NHAS) and learning about what they are doing to support implementation of the Strategy locally. As in other communities across the country, the folks I spoke to in Kansas City and Jefferson City are eager to contribute locally to the nationwide efforts to achieve the Strategy’s goals.

In Kansas City, I spoke to the Campaign to End AIDS (C2EA) Annual Summit. C2EA is a diverse coalition of people living with HIV and AIDS, their advocates, colleagues, friends, and loved ones. The panel discussion in which I participated was entitled “National HIV/AIDS Strategy Implementation: Federal to State to Community.”

The title captures the importance of engaging all sectors of society in implementing the Strategy if we are to achieve its important and life-saving goals. Joining me on that panel was Missouri’s State AIDS Director, Michael Herbert, who shared some of the approaches his agency is taking to align programs and activities with the Strategy’s goals to reduce new HIV infections, increase access to care, and reduce HIV-related health disparities. I provided an overview of what is underway at the Federal level and also encouraged the participants to ground their efforts in science, conduct assessments so they know what works best in their community in terms of prevention and treatment, and scale up those efforts sufficient to meet demand in the communities most impacted.

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